And, presumably, it has other weapons in its arsenal for dealing with fraudulent conduct. Co., Ltd., 842 F.3d 125, 130 (1st Cir. claims . may be available from PACER. The Line: A Man's Experience; A Son's Quest to Understand. 44). The original complaint referred to joint-venture agreements between FMCNA and physicians, but only in order to contrast such agreements (which it referred to as a product of arms-length negotiations) with the higher compensation paid to medical directors in the absence of such agreements.
Whistleblower Lawsuit Against Fresenius Alleges Unlawful .
DOJ files False Claims Act case against dialysis giant Fresenius United States ex rel. Martin Flanagan hasnt hidden himself from view in The Short Long Book but he says he wouldnt trust any journalist who did. 2:22-CV-01807 | 2022-10-21, U.S. District Courts | Personal Injury | The SEC filings at issue state that (1) at most of our clinics, a relatively small number of physicians account for the referral of all or a significant portion of the patient base, (Def. Compl. 45). It employs more than 40,000 employees and treats nearly 190,000 patients at approximately 2,400 outpatient clinics in the United States, including 39 in Massachusetts. Martin Flanagan United States of America Defendant FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North America First, it added a second definition for original source. Id. (Id. 308, 321). The second was that these same doctors are often provided with opportunities to rent office space that they own to Fresenius at above or at the very top of fair market value, with guaranteed long-term leases that are not commercially reasonable. (Id. 494.150; Am. Web1 of 5 stars 2 of 5 stars 3 of 5 stars 4 of 5 stars 5 of 5 stars. Instead, those services were provided free of charge. Duxbury v. Ortho Biotech Prods., L.P., 719 F.3d 31, 33 (1st Cir. See Id. 249 (NANI) (All . F. DENNIS SAYLOR IV, CHIEF JUDGE, UNITED STATES DISTRICT COURT, MEMORANDUM AND ORDER ON DEFENDANT'S MOTION TO DISMISS. See Kelly, 827 F.3d at 15 (It may not be irrational to infer that, given [the allegations of the fraudulent scheme], some false claims . While it is true that it did not use the term medical director agreements, its allegations concerning improper remuneration to physicians in the form of compensation above fair-market value and favorable leases are nonetheless substantially similar to those in the amended complaint. 3730(e)(4)(B) (2006). 02-11738, 2013 WL 682740, at *5 (D. Mass. were false .); id. Previously, Martin was a Direct or, Acute Maket Development Wbd at Fresenius Medical Care North America. 11). Access this case on the Massachusetts District Court's Electronic Court Filings (ECF) System. No published case in the First Circuit, however, has ever gone so far. 97-106). To be clear, the dispositive question is not whether FMCNA engaged in an illegal and pervasive scheme to pay kickbacks for referrals. See East Bay Mun. 2014), the First Circuit affirmed the denial of a motion to amend the complaint a third time. Physicians who wanted to terminate the non-competition agreements were forced to negotiate onerous buyouts. 4:05-cv-985 (E.D. A claim is any request or demand . These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia. [23-1305] (JAW) [Entered: 04/05/2023 09:24 PM]. Medical directors are not FMCNA employees, but physicians in private practice. To register for a PACER account, go the Pacer website at # https://pacer.uscourts.gov/register-account.Pro Hac Vice Admission Request Instructions # https://www.mad.uscourts.gov/caseinfo/nextgen-pro-hac-vice.htm.A Notice of Appearance must be entered on the docket by the newly admitted attorney. 3729(b)(2). Defendant contends that the 2014 CKD complaint alleged the same fraudulent scheme concerning joint-venture agreements as the amended complaint here, which was filed seven years later. This docket was last retrieved on December 5, 2022. Instructions on how to link CM/ECF accounts to upgraded pacer account can be found at # https://www.mad.uscourts.gov/caseinfo/nextgen-current-pacer-accounts.htm#link-account. WebMartin Flanagan is a Director, National of Acute Dialysis Services at Liberty Dialysis based in Anchorage, Alaska. Add to basket. Notice of appeal (doc. A secondary objective was to prevent defendants from having to answer complaints without knowing whether the government or relators would pursue the litigation. Id. In an FCA case, these may include details concerning the dates of the claims, the content of the forms or bills submitted, their identification numbers, the amount of money charged to the government, the particular goods or services for which the government was billed, the individuals involved in the billing, and the length of time between the alleged fraudulent practices and the submission of claims based on those practices. U.S. ex rel. Rather, the complaint must allege both the existence of a scheme and the making of particular false claims resulting from the scheme. 232-35 (Diablo Nephrology in California); id. Westmoreland v. Amgen, 707 F.Supp.2d 123, 130 (D. Mass. (Id. . The Clerks Office nevertheless takes the position that the matter may not reassigned by their corrective action alone but requires some action of a judicial officer under the Local Rules. 01 Jun 2022. This is the same scheme with the same methodology as alleged here. 111-148, 124 Stat. 38). Plaintiff-Relator Martin Flanagan (Relator) worked for Fresenius for twenty-nine years, most recently as Director of Acute Market Development for the 22). 1999)). Accordingly, the claims concerning joint-venture agreements are barred by the first-to-file rule. (Id. A variety of hospitals, nephrologists and nephrology group practices have been specifically identified in the Complaint. Compl.
Martin Currently, Sandra Martin works as a Clinical Application Specialist at Fresenius Medical Care North America. Where the defendant allegedly caused a third party to submit a false claim to the government, rather than submitting the false claim itself, a more flexible standard applies, under which Rule 9(b) is satisfied by providing factual or statistical evidence to strengthen the inference of fraud beyond possibility without necessarily providing details as to each false claim submitted. U.S. ex rel. 111-148, 10104(j)(2), 124 Stat. Previously, Kelly was a Quality Assurance Analyst at S Read More Contact Kelly Flanagan's Phone Number and Email Last Update 3/15/2023 6:18 PM Email k***@fresenius-kabi.com Engage via Email Contact Number (708) ***-**** Engage via
joins whistleblower suit vs. Fresenius As to the claims arising from that scheme, the complaint alleges the following: As set forth above, the allegations of the complaint concerning joint-venture agreements, free services to hospitals and patients, and free practice-management services to physicians will be dismissed for failure to comply with the notification and other requirements of the False Claims Act. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. 2013) (internal quotation marks and citations omitted). WebMartin Flanagan is a Director, National of Acute Dialysis Services at Liberty Dialysis based in Anchorage, Alaska. Each step in that argument relies on an inference: first, the inference that the relevant financial arrangements were intended as kickbacks; second, the inference that every referral to an FMCNA clinic was made as a result of the kickbacks; and third, the inference that every claim for government reimbursement was tainted by the kickbacks. 1:19-OP-45655 | 2019-07-22, U.S. Courts Of Appeals | Property | . Winkelman v. CVS Caremark Corp., 827 F.3d 201, 208 (1st Cir. Access the Case Summary and Docket Report to access additional information about this case on the US Court's PACER system. WebBrigid M. Flanagan, RN, MS, Sean Philpott, PhD, MS, and Martin A. Strosberg, MA, MPH, PhD. . (McManus, Caetlin) (Entered: 11/22/2021), Docket(#15) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #13 Motion for Leave to Appear Pro Hac Vice Added W. Scott Simmer. Martin Flanagan. Family Medicine Call for an The qui tam provisions of the FCA permit relators, in some instances, to reap huge financial windfalls. plaintiff the benefit of all reasonable inferences therefrom. Ruiz v. Bally Total Fitness Holding Corp., 496 F.3d 1, 5 (1st Cir. Unless otherwise noted, the following facts are alleged in the amended complaint. 119 (2010). 3730(b)(2); (2) the claims are barred by the FCA publicdisclosure bar, 31 U.S.C. To do so, the complaint must both allege the existence of a scheme to defraud and identify particularized false claims. 270-84 (ENA and other practices in North Carolina); id. 360 (ENA); id. (Id. Counsel may need to link their CM/ECF account to their upgraded individual pacer account. 2016). The remaining six paragraphs describing the alleged scheme consisted of an introductory paragraph (Compl. WebMichael P. Flanagan, MD. a. D. Pleading Fraud with Particularity under Rule 9(b). One problem lies in the phrase results in-that is, the requirement of causation. Heineman-Guta v. Guidant Corp., 718 F.3d 28, 35-37 (1st Cir. (Id. our revenues would decrease. (Id. 334-35). It might also be entirely rational to shift the burden to the defendant: that is, once a relator has established the existence of a kickback scheme, arguably the burden should be shifted to the defendant to prove that certain referrals were not caused by payment of kickbacks.
Martin Flanagan - Director, Natio.. - Liberty Dialysis UniCourt uses cookies to improve your online experience, for more information please see our Privacy Policy. . As to Scripps, it alleges the following: The complaint further alleges, at considerable length, a scheme to pay medical directors compensation above fair market value in order to induce referrals. (Woodlock, Douglas) (Entered: 11/02/2021), Docket(#7) NOTICE of Appearance by Abraham R. George on behalf of United States of America (George, Abraham) (Entered: 10/18/2021), Docket(#6) MOTION for Leave to Appear Pro Hac Vice for admission of James F. Bennett Filing fee: $ 100, receipt number AMADC-9005666 by Fresenius Medical Care Holdings, Inc.. (Attachments: #1 Affidavit Certification of James F. Bennett)(Durant, Maria) (Entered: 10/13/2021), Docket(#5) MOTION for Leave to Appear Pro Hac Vice for admission of Megan S. Heinsz Filing fee: $ 100, receipt number AMADC-9005610 by Fresenius Medical Care Holdings, Inc.. (Attachments: #1 Affidavit Certification of Megan S. Heinsz)(Durant, Maria) (Entered: 10/13/2021), Docket(#4) NOTICE of Appearance by Maria R. Durant on behalf of Fresenius Medical Care Holdings, Inc. (Durant, Maria) (Entered: 10/07/2021), Docket(#3) NOTICE of Appearance by William H. Kettlewell on behalf of Fresenius Medical Care Holdings, Inc. (Kettlewell, William) (Entered: 10/07/2021), Docket(#2) Case transferred in from District of Maryland; Case Number 14-cv-00665-GLR.
Fresenius WebMartin Flanagan (Author), Andrew Livingstone (Author), Mike McKenny (Author) Paperback $46.95 $42.25 Hardback $190.00 $171.00 Ebook (PDF) $42.25 $33.80 Ebook (Epub & Mobi) $42.25 $33.80 Quantity In stock $171.00 RRP $190.00 Website price saving $19.00 (10%) Add to basket Add to wishlist This product is usually dispatched within 1 week Chief Judge F. Dennis Saylor, IV assigned to case.
2016). (Attachments: #1 Affidavit Certificate of Jamie Bennett in Support of Motion for Appearance Pro Hac Vice)(Sullivan, Christopher) (Entered: 11/22/2021), (#13) MOTION for Leave to Appear Pro Hac Vice for admission of W Scott Simmer Filing fee: $ 100, receipt number AMADC-9065559 by Martin Flanagan. Paperback. MEMORANDUM AND ORDER: This case was erroneously assigned to my docket as a result of a failure by docketing personnel in the Clerks Office to recognize that it is not related to the MDL proceeding assigned to me. After describing that scheme in some detail, the complaint alleges the following as to the submission of actual false claims: The complaint also provides a somewhat more complete description of the false claims for services allegedly provided to Scripps Health, a large health care system with five hospitals in San Diego, California. (Id. Finally, the complaint alleges that medical directors were required to sign agreements containing non-competition provisions in order to preclude any medical director and those in the same practice group from engaging in any remunerative relationship with another dialysis company. (Id. See 31 U.S.C.
were false .); id. The portions of the claims based on those allegations will therefore be dismissed for failing to comply with the FCA's pre-suit requirements. L. No. Public Records Policy. As the Chair of the Local Rules Committee when the relevant rules were adopted, see generally L.R. 3729 et seq., by a company that provides dialysis services to patients with kidney failure. 308-14). 9(b). 2004), abrogated on other grounds by Allison Engine Co. v. United States ex rel. Add to basket. Use the links below to access additional information about this case on the US Court's PACER system. 9(b). In substance, the complaint alleged that FMCNA engaged in a scheme to pay kickbacks to physicians with whom it had entered into joint-venture agreements. by. While it is true that CMS data are reports for the purposes of the public disclosure bar, see U.S. ex rel. If the trial Judge issues an Order of Reference of any matter in this case to a Magistrate Judge, the matter will be transmitted to Magistrate Judge Judith G. Dein. According to ZoomInfo records, Sandra Martins professional experience began in 1986. For the sake of simplicity, the Court will focus first on the Medicare claims. (Id. The plaintiff further recounts various instances where Fresenius leadership was questioned about the fair market value of such relationships and the companys alleged failure to enforce annual contractual rate increases. 238 (Balboa Nephrology Medical Group) (Every claim . The Medicare ESRD program is administered through the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS). 233 (Diablo Nephrology) (Every claim for reimbursement [FMCNA] submitted to [f]ederal health care programs associated with the treatment of these patients was tainted by kickbacks and therefore false within the meaning of the FCA.); id. . for money or property presented to an officer, employee, or agent of the United States. Compl. Second, it alleges that FMCNA engaged in improper remuneration relationships with physicians who served as medical directors in its outpatient clinics in five ways: by selecting medical directors based on their expected and historical referrals; by paying them above-market compensation to reward referrals; by making no effort to report or verify their hours; by tracking their referrals to make sure they were not making referrals to competitors; and by requiring them to sign onerous noncompete agreements to lock them into their arrangements with FMCNA. 12(b)(6) and for failure to allege fraud with particularity as required by Fed.R.Civ.P. Bell Atl. The description of the alleged scheme consisted of 25 paragraphs. I understand that the relevant personnel have since received training to avoid such errors in the future. (Id. Menu and widgets. of Cunningham v. Millennium Lab'ys of Cal., Inc., 713 F.3d 662, 669-70 (1st Cir. By law, all outpatient dialysis clinics must have a qualified medical director to be responsible for the delivery of patient care and outcomes in the facility. 42 C.F.R. In substance, it is a dressed-up version of a generalized allegation: it essentially alleges that if a practice benefited financially from a relationship with FMCNA, and if it administered 104,000 treatments, and 93% of those were to patients who were beneficiaries of government-sponsored healthcare programs, then it submitted 96,720 false claims. Flanagan v. Fresenius Medical Care Holdings, Inc. Martin Flanagan and United States of America, FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North America, US District Court for the District of Massachusetts.
Although the budgetary spreadsheets were reviewed and approved by mid-level and upper management, the complaint alleges that the decision to run hospital programs at a loss was made by corporate management.
The Crusader Takes a Closer Look: The Dialysis Hustle Part 2 June 11, 2014). In affirming that decision, the First Circuit stated that the new paragraphs in the [p]roposed [complaint] were attributable to the new relator and . If the government declines to intervene and the qui tam case is unsealed, further proceedings are governed by 31 U.S.C. President, National Cardiovascular Partners; President, Spectra Laboratories. . b. It also contracts with hospitals to provide dialysis services on an outpatient basis. See U.S. ex rel. (g), I respectfully disagree with that interpretation. 3730(e)(4)(A). to purchase . (Id. Finally, one place to get all the court documents we need. A medical director's productivity was tracked, and contracts with medical directors who generated a large number of patients were renewed. no person other than the Government may intervene or bring a related action based on the facts underlying the pending action. 31 U.S.C. (McManus, Caetlin) (Entered: 11/22/2021), (#14) MOTION for Leave to Appear Pro Hac Vice for admission of Jamie Bennett Filing fee: $ 100, receipt number AMADC-9065597 by Martin Flanagan. 88). MARTIN FLANAGAN, Plaintiff-Relator, v. FRESENIUS, Court:United States District Court, D. Massachusetts. 15). According to the complaint, FMCNA also paid physician groups rent above fair market value and provided leases below fair market value in order to secure referrals. 308-20). 368-74). 2019) (cleaned up). Here, despite its length, the amended complaint does not describe a single particular false claim. Attorneys admitted Pro Hac Vice must have an individual upgraded PACER account, not a shared firm account, to electronically file in the District of Massachusetts. Want to Read. As set forth above, the complaint alleges that FMCNA provided dialysis services to hospitals at prices well below cost in order to capture referrals of discharged patients to its dialysis clinics. According to the complaint, [f]or this reason, claims submitted to the state Medicaid agencies are presented to the federal government within the meaning of the [False Claims Act]. (Id.). . (Id. v. Balfour Beatty Infrastructure, Inc., 2014 WL 2611312, at *2 (N.D. Cal. FMCNA generated reports to track which medical directors and their practice groups referred patients to outside clinics and the reasons why. Co. Ltd., 737 F.3d 116, 123 (1st Cir. 3/17/2023 8:35 PM. There must be particularized allegations of claims for payment arising from that scheme. Martin L. Flanagan is a businessperson who has been at the helm of 13 different companies. 3729(a)(1)(B) (Count 2); and conspiring to present false claims and making or using false records material to a false or fraudulent claim in violation of the False Claims Act, 31 U.S.C. FMCNA then moved to dismiss the complaint. However, the First Circuit has rejected the holding in Poteet, explaining that earlier-filed complaints must provide only the essential facts to give the government sufficient notice to initiate an investigation into allegedly fraudulent practices and emphasizing that Section 3730(b)(5) contains no exceptions. United States ex rel. WebSenior Vice President of Strategic Business Integrations Fresenius Medical Care. And even though the regulatory guidance defines the medicaldirector position as occupying 0.25 FTE, the complaint alleges that FMCNA neither tracked nor enforced medical directors' hours spent on duties to their clinics. any good, facility, service, or item for which payment may be made in whole or in part under a Federal health care program shall be guilty of a felony. 359 (NANI); id.
Martin Flanagan To register for a PACER account, go the Pacer website at # https://pacer.uscourts.gov/register-account.Pro Hac Vice Admission Request Instructions # https://www.mad.uscourts.gov/caseinfo/nextgen-pro-hac-vice.htm.A Notice of Appearance must be entered on the docket by the newly admitted attorney. Free Services to Hospitals and Patients. To survive a motion to dismiss, a complaint alleging fraud must state with particularity the circumstances constituting fraud. Fed.R.Civ.P.
Flanagan v. Fresenius Medical Care Holdings, Inc., No. The complaint alleges various methods by which FMCNA improperly induced the referral of patients to its dialysis clinics. WebView the profiles of people named Martin Flanagan. 361 (Dallas Nephrology Associates)). The complaint must set forth with particularity the who, what, when, where, and how of the alleged fraud. U.S. ex rel. The False Claims Act permits relators to reap substantial awards for reporting false claims to the government-in this case, the relator could conceivably recover billions of dollars if his allegations are proved. (McManus, Caetlin) (Entered: 11/02/2021), Docket(#10) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #5 Motion for Leave to Appear Pro Hac Vice Added Megan S. Heinz. #57) filed by Appellant Martin Flanagan. It includes a blank example of such a form as Exhibit A.
Flanagan v. Fresenius Medical Care Holdings, Inc. Martin Flanagan's Phone Number and Email Last Update. . occurred; (2) said disclosure . . 3729(a)(1)(C) (Count 3). It then alleges: Similarly, for North Carolina, the complaint provides a table of Medicaid (but not Medicare) revenue for a period of six years at fourteen dialysis centers. Patients who were referred to non-FMCNA clinics were categorized as leakage. (Id. US$184.67 US$190.00. Defendant further contends that the CIA it had entered into with the OIG relating to conduct of a company FMCNA later acquired (National Medical Care) qualified as a public disclosure. First, the complaint alleges in general terms that all claims for reimbursement made to Medicare require the submission of a Form UB-40 (or a substantially similar form) that contains various data, including the patient's identifying information and line items for each claim sought to be reimbursed. (Am. Defendant further contends that the original complaint did not contain any allegations concerning medical-director agreements, and that all claims based on such agreements should likewise be dismissed. The first was that these physicians were generally paid in excess of fair market value for the services they actually rendered. (Id.). In that role, he was responsible for, among other duties, negotiating contracts under which FMCNA provided dialysis treatment to hospital inpatients. . Now, a relator may also qualify as an original source if prior to a public disclosure under subsection (e)(4)(a), [he] voluntarily disclosed to the Government the information on which allegations or transactions in a claim are based. Id. 13 at 23); and that (3) If physicians and other referral sources cease referring patients to our dialysis clinics . 2009). Submission of claims to Medicaid that were ineligible for payment because of violation of the AKS are actionable under the FCA because the payments of those claims were made with federal funds. 28). Previously, Martin was a Direct or, Acute Maket Development Martin Flanagan and United States of America: Defendant: FRESENIUS MEDICAL CARE HOLDINGS, INC. doing business as Fresenius Medical Care North 110-11). 23-7001 | 2023-01-06, U.S. District Courts | Personal Injury | (Id. It then used that data to identify physicians and practice groups to target for medical director positions and joint-venture agreements. Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. As to the appellee L. Martin Flanagan, we affirm. The complaint describes a culture of doing whatever it takes to enter into hospital contracts to secure patient referrals for Fresenius outpatient dialysis centers. (McManus, Caetlin) (Entered: 11/22/2021), (#15) Chief Judge F. Dennis Saylor, IV: ELECTRONIC ORDER entered granting #13 Motion for Leave to Appear Pro Hac Vice Added W. Scott Simmer. (Id. Currently, Mr. Flanagan is President, Chief Executive Officer & Director at Invesco Ltd. Mr. Flanagan is also Chairman at Metro Atlanta Chamber of Commerce and on the board of 19 other companies. The Clerks Office nevertheless takes the position that the matter may not reassigned by their corrective action alone but requires some action of a judicial officer under the Local Rules. (Am. 2016) (citing Duxbury I, 579 F.3d at 29). 247-48). 25) and five paragraphs addressing how the scheme resulted in false claims (Id. In any event, as to those aspects of the alleged scheme, the allegations of the submission of false claims are similarly general. At most, the filings describe a set of circumstances that might be vulnerable to manipulation. United States ex rel. Again, those claims will be dismissed on other grounds; however, even if those claims survived those challenges, they are duplicative of the allegations in CKD and therefore would be barred by the first-to-file rule. To register for a PACER account, go the Pacer website at # https://pacer.uscourts.gov/register-account.Pro Hac Vice Admission Request Instructions # https://www.mad.uscourts.gov/caseinfo/nextgen-pro-hac-vice.htm.A Notice of Appearance must be entered on the docket by the newly admitted attorney. . As to Medicaid, the complaint alleges in general terms that state administrators of the program obtain reimbursement from the federal government by submitting a quarterly Form 64 to the Centers for Medicare and Medicaid Services at Department of Health and Human Services. (Id. (Id. On February 5, 2021 a long-time former Fresenius Medical Care North America (Fresenius) employee, Martin Flanagan, filed a qui tam relator amended It identifies specific hospitals, doctors, and medical practices that have allegedly benefited financially from the scheme. See 31 U.S.C. 13). 154). The complaint alleges that the Bridge Program was actually designed to capture all of a hospital's referrals, as about half of the company's patients came into [FMCNA] clinics via [the discharge planning process]. (Id. constitutes a false claim.); id.